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目的:综述白消安在造血干细胞移植中的应用及其治疗药物监测研究进展。方法:查阅国内外相关文献,对有代表性的文献进行分析、归纳、总结。结果:白消安作为造血干细胞移植预处理方案的主要药物之一在恶性血液病治疗中发挥重要作用;白消安的治疗窗为口服给药Css600～900μg·L-1(相当于AUC0-6h875～1315μmol·L-1.min),静脉给药AUC0-6h900～1500μmol·L-1·min(相当于Css660～1025μg·L-1),超出此范围易产生肝脏静脉阻塞性疾病(VOD)等严重不良反应,移植后长期生存率降低,低于此浓度则造血干细胞不易植入或容易出现白血病复发;口服白消安体内过程个体差异大、需进行治疗药物监测,正逐渐被静脉用白消安替代。结论:探索适合我国患者的白消安治疗浓度窗以及静脉滴注白消安的用药方式,对于提高白消安预处理方案的临床效果,提高HSCT治疗恶性血液病的水平,具有十分重要的意义。
Objective: To summarize the clinical application of busulfan in hematopoietic stem cell transplantation and its research progress in therapeutic drug monitoring. Methods: Access to relevant literature at home and abroad, analysis of representative documents, summarized, summarized. Results: Busulfan as one of the main drugs for hematopoietic stem cell transplantation preconditioning regimen plays an important role in the treatment of hematologic malignancies. The therapeutic window of busulfan is oral administration of C600 ~ 900μg · L-1 (equivalent to AUC0-6h875 ~ 1315μmol·L-1.min), intravenous administration of AUC0-6h900 ~ 1500μmol·L-1 · min (equivalent to Css660 ~ 1025μg · L-1), beyond this range prone to liver vein occlusive disease (VOD), etc. Serious adverse reactions, long-term survival rate decreased after transplantation, below this concentration is not easy to implant hematopoietic stem cells or prone to recurrence of leukemia; oral prednisone in vivo process individual differences, the need for treatment of drug monitoring, is gradually being intravenous An alternative. CONCLUSION: It is of great significance to explore the clinical efficacy of busulfan pretreatment regimen and to improve the level of HSCT in the treatment of hematological malignancies by investigating the dosage regimen of busulfan for treating patients in our country and intravenous busulfan. .